ADOPTION APPLICATION

In order that we may be assured that the animal you are applying for will be best suited to your home and lifestyle, and that it will be placed in an environment that is compatible with its needs, please read the below agreement and fill out the application completely.

Please use N/A (Not Applicable) where necessary - do not leave anything blank.

Failure to fill out application completely may result in a denial of application.

ATTENTION:

Completion of this agreement does NOT guarantee that you will be approved for the adoption of this pet. Good Karma Dog Rescue, Inc. (GKDR), is dedicated to placing our pups in the best homes possible. Therefore, we may decide to take more than one application on any of our animals and will contact references that you have provided to ensure that we make the best decision for both the potential adopting individual/family and the pet. We appreciate your patience while we make our decision.

Full name of applicant who will be responsible for this dog: *

Full name of applicant who will be responsible for this dog:

First Name

Last Name

Date of Birth

Date of Birth

MM

DD

YYYY

Name of pet that you are interested in adopting: *

How did you hear about this dog?

Email Address: *

Address: *

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone:

Cell:

Are you on Facebook?

YES

NO

FB name

Place of Employment

Work Phone

Work Phone

(###)

###

####

What qualities are you looking for in a pet?

Please list all adults (over the age of 18) living at this residence:

Are all adults living in this household agreeable to adopting this dog?

Yes

No

Uncertain

Number of children living in household and ages:

Does anyone in the household have allergies to animals?

Yes

No

Is this adoption a gift for someone else?

Yes

No

If "Yes", please explain:

Will the dog be kept at a different address?

Yes

No

What type of residence do you live in?

Single Family

Duplex

Townhouse

Condominium

Mobile Home

Military Housing

Do you own or rent your residence? *

Own

Rent

How long have you been at this residence?

If you rent, please supply the name and contact number for your landlord:

Does your property have a front/backyard?

Frontyard

Backyard

Both

Is the yard enclosed with fencing?

Yes, Totally fenced in

Yes, Partially fenced in

No

If "yes", what type of fencing?

Privacy

Chain Link

Invisible

Where will this pet live? (Check all that apply)

Indoors

Outdoors

Screened Porch/Garage

Option Two

How many hours/day on average will the dog be home alone?

How will this pet spend its time home alone? (Check all that apply)

Indoors, No restriction

Indoors, Crated/kenneled

Indoors, Room restricted

Outdoors, No restrictions

Outdoors, Yard/Kennel

Outdoors, Chained

Where will this pet sleep at night?

Will any other pets be in contact with your new pet on a regular basis?

Yes

No

If yes, please explain:

How are you planning to socialize and exercise this pet?

If you move, are you willing to bring this animal to live with you in your new residence?

Are you willing to participate in training programs or behavior classes if your pet requires it?

Yes

No

Please initial or sign after reading and agreeing to these terms: GKDR believes that all pets should be indoor-only pets. The animals we adopt out are never to be allowed to roam outside due to the potential hazard of getting hit/run over by vehicles, injuries from other wild or domesticated animals/spreading of disease. *

Please initial or sign after reading and agreeing to these terms: GKDR believes that all pets should be indoor-only pets. The animals we adopt out are never to be allowed to roam outside due to the potential hazard of getting hit/run over by vehicles, injuries from other wild or domesticated animals/spreading of disease.

First Name

Last Name

Good Karma Dog Rescue has a “no refund” policy. Is this acceptable to you? *

Yes

No

Please initial or sign after reading and agreeing to these terms: Good Karma Dog Rescue reserves the right to reclaim any animal that is found chained or bound in an inappropriate manner, abused, neglected, or improperly cared for. *

Please initial or sign after reading and agreeing to these terms: Good Karma Dog Rescue reserves the right to reclaim any animal that is found chained or bound in an inappropriate manner, abused, neglected, or improperly cared for.

First Name

Last Name

Pledge I pledge to make a reasonable commitment of time and effort and to adjust scheduling and lifestyle in order to make this relationship work. I understand that I may need to confine and seclude this pet in my home in order to provide an adjustment period and build a relationship by earning his/her trust. *

Pledge I pledge to make a reasonable commitment of time and effort and to adjust scheduling and lifestyle in order to make this relationship work. I understand that I may need to confine and seclude this pet in my home in order to provide an adjustment period and build a relationship by earning his/her trust.

First Name

Last Name

RELEASE OF LIABILITY: I, release GKDR, volunteers, foster volunteers and representatives of GKDR from any and all claims and actions, whether it’s for property damage caused by the animal(s) or for personal injury to me, family members, other persons and other animals (including personal pets, livestock, or other animals) from biting, scratching, transmittal of disease, and/or any other matter attributable to said animal(s). *

RELEASE OF LIABILITY: I, release GKDR, volunteers, foster volunteers and representatives of GKDR from any and all claims and actions, whether it’s for property damage caused by the animal(s) or for personal injury to me, family members, other persons and other animals (including personal pets, livestock, or other animals) from biting, scratching, transmittal of disease, and/or any other matter attributable to said animal(s).

First Name

Last Name

MEDICAL RELEASE OF LIABILITY: Good Karma Dog Rescue will not be responsible for any medical bills for your pet after adoption unless arranged for at time of adoption. *

MEDICAL RELEASE OF LIABILITY: Good Karma Dog Rescue will not be responsible for any medical bills for your pet after adoption unless arranged for at time of adoption.

First Name

Last Name

I/We further understand and agree: 1. To return the dog to GKDR if unable to keep the dog. To never abandon the dog or surrender, sell, or give the dog to a shelter, pet dealer, or a laboratory. 2. To notify GKDR if the dog is lost or stolen and to make all reasonable efforts to locate the dog. 3. To never allow this dog to be trained for or used for protection or as an attack dog. 4. To treat this dog as a family pet with affection and kindness, never subjecting this dog to abuse or cruelty. 5. To provide regular veterinary care, including annual shots, heartworm preventative, and parasite checks. 6. To always keep this dog within a fenced yard (not on a chain), on a leash, or safely within the home. 7. To not transport this dog unconfined in an open vehicle. 8. To regularly check the tightness of any collar. To affix any licenses and tags to the collar and to never leave a choke chain on the dog when not attended. 9. To permit GKDR to make follow-up calls and/or visits. 10. To contact GKDR, a veterinarian, or an obedience trainer when problems arise so that the problem may be eliminated or alleviated. I/We further understand and agree that: 1. Non-compliance with any of the above terms and conditions may result in the immediate forfeiture of the dog and that GKDR may reclaim this dog without payment of compensation to me/us. 2. GKDR has explained the typical characteristics and temperament of the pet. 3. GKDR has advised me/us that the dog can sometimes dig, chew, soil, and exhibit other undesirable traits unless properly supervised, confined, and trained. 4. GKDR has given me all information necessary to make an informed decision to adopt this dog. In consideration of the adoption of this dog, I/we agree to assume full responsibility for the conduct of this dog upon the date of this contract. I/we further agree to hold harmless GKDR, its volunteers, and any individuals associated with GKDR and to indemnify such organizations or individuals for any damages or costs resulting from liability, known or unknown, anticipated or unanticipated, as a result of the dog's conduct after the date of this adoption contract. I have read the terms of this application and the adoption of the pet that I am applying for, and by signing below I certify that the information I gave in this application is true, and any misrepresentation of facts may result in my losing the privilege of adopting a pet through GKDR in the future and the forfeiture of this dog or cat. Also by signing below I agree to all the terms as set forth herein by GKDR in this application. *

I/We further understand and agree: 1. To return the dog to GKDR if unable to keep the dog. To never abandon the dog or surrender, sell, or give the dog to a shelter, pet dealer, or a laboratory. 2. To notify GKDR if the dog is lost or stolen and to make all reasonable efforts to locate the dog. 3. To never allow this dog to be trained for or used for protection or as an attack dog. 4. To treat this dog as a family pet with affection and kindness, never subjecting this dog to abuse or cruelty. 5. To provide regular veterinary care, including annual shots, heartworm preventative, and parasite checks. 6. To always keep this dog within a fenced yard (not on a chain), on a leash, or safely within the home. 7. To not transport this dog unconfined in an open vehicle. 8. To regularly check the tightness of any collar. To affix any licenses and tags to the collar and to never leave a choke chain on the dog when not attended. 9. To permit GKDR to make follow-up calls and/or visits. 10. To contact GKDR, a veterinarian, or an obedience trainer when problems arise so that the problem may be eliminated or alleviated. I/We further understand and agree that: 1. Non-compliance with any of the above terms and conditions may result in the immediate forfeiture of the dog and that GKDR may reclaim this dog without payment of compensation to me/us. 2. GKDR has explained the typical characteristics and temperament of the pet. 3. GKDR has advised me/us that the dog can sometimes dig, chew, soil, and exhibit other undesirable traits unless properly supervised, confined, and trained. 4. GKDR has given me all information necessary to make an informed decision to adopt this dog. In consideration of the adoption of this dog, I/we agree to assume full responsibility for the conduct of this dog upon the date of this contract. I/we further agree to hold harmless GKDR, its volunteers, and any individuals associated with GKDR and to indemnify such organizations or individuals for any damages or costs resulting from liability, known or unknown, anticipated or unanticipated, as a result of the dog's conduct after the date of this adoption contract. I have read the terms of this application and the adoption of the pet that I am applying for, and by signing below I certify that the information I gave in this application is true, and any misrepresentation of facts may result in my losing the privilege of adopting a pet through GKDR in the future and the forfeiture of this dog or cat. Also by signing below I agree to all the terms as set forth herein by GKDR in this application.

First Name

Last Name

Date

Date

MM

DD

YYYY

Thank you for submitting your application. Your application will be forwarded to the Good Karma Dog Rescue Board of Directors for screening.

We will reach out to you as soon as possible to discuss the next step.

• The general adoption process is as follows:

• Once we receive your application, the Good Karma Dog Rescue Board of Directors will review it to see if the dog you are interested in may be compatible with your family.

• Once your application has been screened, we will arrange a meet and greet with you and your family members (including pets) and the dog you are interested in.

• During this time, one of our foster coordinators will be contacting your references and your veterinarian.

• If the meet and greet was successful, and any other potential adopters have been ruled out, we will move ahead with the adoption.

Thank you again. Please do not hesitate to reach out with any additional questions.